Provider Demographics
NPI:1932712577
Name:FOX, SHAWNA (MS)
Entity type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SHAWNA
Other - Middle Name:
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS
Mailing Address - Street 1:1400 W BENSON BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3677
Mailing Address - Country:US
Mailing Address - Phone:907-929-4009
Mailing Address - Fax:907-929-4902
Practice Address - Street 1:1400 W BENSON BLVD STE 315
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3677
Practice Address - Country:US
Practice Address - Phone:907-929-4009
Practice Address - Fax:907-929-4902
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health